Anna Sigríður Ólafsdóttir, PromoKids Workshop 3 October 2018 in Reykjavik.

1. Practical approach to treatment
of pediatric obesity
– tools and experiences
Anna S Olafsdottir, Phd in Nutrition Science
Head of Faculty of Health Promotion, Sport and Leisure Studies
& Landspitali University Hospital

2. The Health School
Family-based behavioral treatment for obese children and their families

3. Important – multidisciplinary team
• Clinic & researchers

4. The start of our FBBT 2007
• PhD project
• Based on the success of Epstein in USA
• Much need for amendment
• Cultural sensitivity
• Users of the program different
• Nutrition guidelines and rules
• Physical Activity

6. Higher than in most studies – small group –
labour intense – very personal

7. …then see the more practical approach on a later slide
The optimal approach according
to research…

8. Strong focus on wellbeing
• In the intervention study performed
• Psychological wellbeing improved and treatment effects were maintained at
1-y follow-up
• Co-morbidities/disorders have to be considered
• Less reduction in BMI-SDS during treatment if children with ADHD
• Social anxiety showed better outcomes – and more reduction in BMI-SDS than those
with lower scores (MASC; Multidemensional Anxiety Scale for Children, subscale)
• High levels of Peer problems (93%)

11. Good results for those finishing the study
 Pediatric quality of life – self-reports and parent reports show improvement
 Average decrease in BMI-SDS (age-corrected) around 0.5. More for boys than girls
and success associated with participation and follow-ups.
 Follow their „new“ weight-trajectory
 Double their intake of fruit and vegetables within 18 weeks of treatment (study) –
from 1.5 up to 3 servings.
 With less intensity this increase was reduced

12. How far can you stretch?...
• Approach may
be to intense
or difficult to
understand
• Time
• Other issues
• Nutrition and
PA literacy

13. Difficult to increase vegetable
and fruit consumption

14. Changes in dietary behavior
• Two examples:
Fruit and vegetables – increasing intake
Soda – decreasing intake

15. Boys – the healthy choice
Units are in
portions/week
Should be at last 14
if 2-3 portions daily

16. Girls – the healthy choice
HPHS (HeF) initiated
2010 in green school

17. Soda
Blue and
orange have
started
initiation in
2010
1 glass/day or more
Non-drinkers

18. Health school – since 2011

21. Tools – examples for
nutrition

24. Hver og einn með sérsniðna
markmiðasetningu

25. Takið eftir svefninum!

26. The Hunger Meter helps YOU and Yip decide
WHEN to eat.
Every time Yip wants to eat, stop and
look at the Hunger Meter.
Ask Yip, “ Are you really hungry or do
you just want to eat?”
Yip doesn’t need to eat every time he
wants to eat.
When Yip isn’t really hungry, help Yip
find something else fun to do.
Help Yip learn to wait for meals and
snacks.
Linda Craighead

27. Appetite awareness training - AAT

29. Finnland Svíþjóð Danmörk

30. Heimild: Tekið í taumana. Lýðheilsustöð, 2007
http://www2.lydheilsustod.is/media/manneldi/utgefid/tekid_i_taumana2.pdf
2-3
Ekki gleyma lýsinu!
~5
~5
~5

31. Portion control
Próteingjafar, brauðsneiðar
Ávextir, grænmeti, meðlæti
Fita og sykur – viðbit og sósur
Höndin stækkar með barninu samhliða því sem orkuþörfin eykst

32. Depending on definition 31-40% fussy eaters